JOPLIN, Mo. — A spokeswoman for the southwest Missouri city of Joplin says the death toll from a tornado that pounded the city could top two dozen, and there are fears that number is low.

Joplin spokeswoman Lynn Onstot was asked early Monday about an earlier report the storm had killed 24 people. She responded grimly that the city is “afraid it may be more. … Our fear is that’s a low number.”

Officials struggling to communicate without power and cell phone service have been leery of putting a hard figure on a death toll.

The Missouri National Guard is continuing its search for the injured throughout the night.

The storm left behind piles of brick and wood where homes once stood. Cars were ripped apart and thrown on top of each other. A wrecked helicopter lay on its side in front of a damaged hospital. All that was left on one hillside was bare trees, stripped of their leaves and branches. The devastation was reminiscent of Tuscaloosa, Ala., where 41 people were killed in a tornado last month.

Triage centers and shelters were setup around the city. At Memorial Hall, a downtown entertainment venue, nurses and other emergency workers from area hospitals were treating critically injured patients.

Hundreds of windows were blown out at St. John’s Regional Medical Center, where a few moments’ notice gave staff time to hustle patients into hallways before the tornado struck the multistory building. All were evacuated and moved to other hospitals in the region.

The same storm system that produced the Joplin tornado spawned twisters along a broad swath of the Midwest, from Oklahoma to Wisconsin. At least one person was killed in Minneapolis.

The storm that hit Joplin spread debris about 60 miles away, with medical records, X-rays, insulation and other items falling to the ground in Greene County, said Larry Woods, assistant director of the Springfield-Greene County Office of Emergency Management.

Emergency management officials rushed heavy equipment to Joplin to help lift debris and clear the way for search and recovery operations. Gov. Jay Nixon activated the National Guard and declared a state of emergency. Schools in the disaster zoned were flattened or severely damaged.

Phone communications in and out of the city of about 50,000 people about 160 miles south of Kansas City were largely cut off.

Travel through and around Joplin was difficult, with Interstate 44 shut down and streets clogged with emergency vehicles and the wreckage of buildings.

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